Sick in first trimester

Vomiting and morning sickness - NHS

Nausea and vomiting in pregnancy, often known as morning sickness, is very common in early pregnancy.

It can affect you at any time of the day or night or you may feel sick all day long.

Morning sickness is unpleasant, and can significantly affect your day-to-day life. But it usually clears up by weeks 16 to 20 of your pregnancy and does not put your baby at any increased risk.

There is a chance of developing a severe form of pregnancy sickness called hyperemesis gravidarum. This can be serious, and there's a chance you may not get enough fluids in your body (dehydration) or not get enough nutrients from your diet (malnourishment). You may need specialist treatment, sometimes in hospital.

Sometimes urinary tract infections (UTIs) can also cause nausea and vomiting. A UTI usually affects the bladder, but can spread to the kidneys.

Non-urgent advice: Call your midwife, GP or 111 if:

you're vomiting and:

• have very dark-coloured urine or have not had a pee in more than 8 hours
• are unable to keep food or fluids down for 24 hours
• feel severely weak, dizzy or faint when standing up
• have tummy (abdominal) pain
• have a high temperature
• vomit blood
• have lost weight

Treatments for morning sickness

Unfortunately, there's no hard and fast treatment that will work for everyone’s morning sickness. Every pregnancy will be different.

But there are some changes you can make to your diet and daily life to try to ease the symptoms.

If these do not work for you or you're having more severe symptoms, your doctor or midwife might recommend medicine.

Things you can try yourself

If your morning sickness is not too bad, your GP or midwife will initially recommend you try some lifestyle changes:

• get plenty of rest (tiredness can make nausea worse)
• avoid foods or smells that make you feel sick
• eat something like dry toast or a plain biscuit before you get out of bed
• eat small, frequent meals of plain foods that are high in carbohydrate and low in fat (such as bread, rice, crackers and pasta)
• eat cold foods rather than hot ones if the smell of hot meals makes you feel sick
• drink plenty of fluids, such as water (sipping them little and often may help prevent vomiting)
• eat foods or drinks containing ginger – there's some evidence ginger may help reduce nausea and vomiting (check with your pharmacist before taking ginger supplements during pregnancy)
• try acupressure – there's some evidence that putting pressure on your wrist, using a special band or bracelet on your forearm, may help relieve the symptoms

Find out more about vitamins and supplements in pregnancy

Anti-sickness medicine

If your nausea and vomiting is severe and does not improve after trying the above lifestyle changes, your GP may recommend a short-term course of an anti-sickness medicine, called an antiemetic, that's safe to use in pregnancy.

Often this will be a type of antihistamine, which are usually used to treat allergies but also work as medicines to stop sickness (antiemetic).

Antiemetics will usually be given as tablets for you to swallow.

But if you cannot keep these down, your doctor may suggest an injection or a type of medicine that's inserted into your bottom (suppository).

See your GP if you'd like to talk about getting anti-sickness medication.

Risk factors for morning sickness

It's thought hormonal changes in the first 12 weeks of pregnancy are probably one of the causes of morning sickness.

But you may be more at risk of it if:

• you're having twins or more
• you had severe sickness and vomiting in a previous pregnancy
• you tend to get motion sickness (for example, car sick)
• you have a history of migraine headaches
• morning sickness runs in the family
• you used to feel sick when taking contraceptives containing oestrogen
• it's your first pregnancy
• you're obese (your BMI is 30 or more)
• you're experiencing stress

Visit the pregnancy sickness support site for tips for you and your partner on dealing with morning sickness.

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Video: how can I cope with morning sickness?

In this video, a midwife gives advice on how to deal with morning sickness during your pregnancy.

Media last reviewed: 27 February 2017
Media review due: 27 March 2020

Page last reviewed: 13 April 2021
Next review due: 13 April 2024

Severe Morning Sickness (Hyperemesis Gravidarum) (for Parents)

What's Morning Sickness?

During the first trimester of pregnancy, many women have the bouts of nausea and vomiting known as morning sickness.

Despite its name, morning sickness can happen day or night. It usually starts around the 6th week of pregnancy, is at its worst around week 9, and stops by weeks 16 to 18. Although unpleasant, morning sickness is considered a normal part of a healthy pregnancy.

What’s Severe Morning Sickness?

Severe morning sickness is when nausea and vomiting get so serious that a pregnant woman vomits several times a day, loses weight, and gets dehydrated or is at risk for dehydration.

If this rare pregnancy-related condition isn’t treated, it can affect a woman's health and her baby's ability to thrive.

The medical term for severe morning sickness is "hyperemesis gravidarum" (hi-per-EM-eh-sis grav-ih-DARE-um), which means "excessive vomiting during pregnancy." It usually follows a similar timeline to normal morning sickness. But it can go longer, sometimes lasting for the whole pregnancy. Often, the symptoms get less severe as the pregnancy continues.

Most cases of hyperemesis gravidarum affect a woman's first pregnancy. But women who have it in one pregnancy are more likely to have it in future pregnancies.

What Causes Severe Morning Sickness?

The cause of severe morning sickness isn’t known. But it might be related to the hormone changes of pregnancy. A hormone called human chorionic gonadotropin, or HCG, might be to blame because severe morning sickness most often happens when HCG levels are at their highest in a pregnant woman's body.

Severe morning sickness also might run in families. It’s more common in women whose close family members (such as mothers and sisters) have had it.

Other things that can increase a woman's chances of having severe morning sickness include:

• carrying multiples (twins, triplets, etc.)
• history of motion sickness
• migraine headaches with nausea or vomiting

What Problems Can Happen?

The nausea and vomiting that happen in severe morning sickness are so extreme that they can harm the mother and the baby. Not being able to keep down food makes it hard for the mom to meet her nutritional needs. So she might lose weight. And a loss of fluids, combined with the loss of stomach acid from vomiting, can cause dehydration and electrolyte imbalances.

If severe morning sickness isn’t treated, it can cause many problems, including organ failure and the early birth of her baby.

When Should I Call the Doctor?

Call the doctor right away if you’re pregnant and have any of these symptoms:

• nausea that lasts throughout the day, making it impossible to eat or drink
• vomiting three to four times per day or not being to keep anything in the stomach
• brownish vomit or vomit with blood or streaks of blood in it
• weight loss
• fainting or dizziness
• peeing less than usual
• a fast heart rate
• a lot of headaches
• unpleasant, fruity mouth or body odor
• extreme tiredness
• confusion

How Is Severe Morning Sickness Treated?

Treatments used for morning sickness, such as eating dry crackers in the morning or a bland diet, may be recommended for women with extreme morning sickness. But these might not help with severe symptoms.

Medical treatment can include:

• a short period of not eating to rest the gastrointestinal system
• intravenous (IV) fluids
• vitamin and nutritional supplements

Some women might get medicine to stop the vomiting, either by mouth or through an IV. The doctor might recommend eating foods with ginger or taking vitamin B6 supplements to help ease nausea. It can also help to:

• Eat a bland diet.
• Eat frequent small meals.
• Drink plenty of liquids when not feeling nauseated.
• Avoid spicy and fatty foods.
• Eat high-protein snacks.
• Avoid sensory stimuli that can act as triggers (like specific smells or noises).

If a woman feels anxious or depressed about her condition, talking to a therapist or counselor might help her cope with her feelings.

What Else Should I Know?

With treatment, women with severe morning sickness can feel better and get the nourishment they need so they and their babies thrive. And lifestyle changes can help ease nausea and vomiting and make the pregnancy more enjoyable.

With time, symptoms usually do improve. And, of course, they stop by the time a woman's next journey starts: parenthood.

Why pulls the stomach in the early stages of pregnancy?

Why does the stomach pull in the early stages of pregnancy? This question often worries expectant mothers, and at times leads to panic. When is discomfort pathology, and when is it normal?

Pregnancy is a special time for a mother and her baby. After all, the connection between them is inextricable, and every negative influence or stress affects both of them.

Possible causes of pain

Every woman dreams of having an easy pregnancy and no cause for alarm. However, a very common complaint among pregnant women is pain in the lower abdomen of a pulling or aching nature.

Complaints are so common that it is necessary to clearly understand when pulling sensations during pregnancy are pathological and require immediate medical attention, and when they are completely physiological and require only general recommendations. nine0003

Of course, pain in the lower abdomen can appear at any stage of pregnancy, however, most often women notice their appearance in the early stages of pregnancy.

Painful sensations in the abdomen during pregnancy are very diverse both in subjective sensations and in their localization, in intensity of occurrence. Pain can appear both at rest and after any physical activity. Unpleasant sensations can manifest themselves in one place, or radiate to other areas. nine0003

Unpleasant sensations in the lower abdomen are rarely avoided during pregnancy. These sensations can occur not only in pathology. During pregnancy, the uterus increases in size, there is a tension in its ligaments and muscles. In addition, there is a displacement of the pelvic organs. All this leads to the appearance of pulling or aching sensations in the abdomen. All these phenomena are manifestations of physiological changes that occur to a woman during pregnancy.

Of course, this state of fear does not cause and does not require any intervention on the part of the doctor. However, pulling pains in the lower abdomen are not always a physiological process. It happens that this indicates that the pregnancy proceeds with pathology and requires medical adjustment. nine0003

That is why, if there are pulling or aching pains in the lower abdomen, it is necessary to contact an obstetrician-gynecologist in order to accurately determine the cause of the pain.

Never self-medicate. Remember that you are responsible not only for yourself, but also for the little man that you carry under your heart.

Abdominal pain during pregnancy may be:

• obstetric;
• "non-obstetric".

Pain associated with pregnancy may be developmental:

• physiological changes during pregnancy;
• threatened miscarriage;
• missed pregnancy;
• ectopic pregnancy.

Pain not associated with pregnancy may occur with:

• inflammatory processes;
• pathologies of the digestive system;
• surgical diseases;
• diseases of other organs or systems.

Pain in the lower abdomen during pregnancy as a variant of the norm

Not all pain in the lower abdomen during pregnancy is a manifestation of pathology. Sometimes they can occur during the normal course of pregnancy.

As a physiological process, pain in the lower abdomen can occur in the following situations:

1. sign of pregnancy;
2. displacement of the pelvic organs by the growing uterus;
3. stretching of the ligaments and muscles associated with the growth of the uterus. nine0034

Abdominal pain is a sign of pregnancy

Finding out that you are pregnant is now not a big deal, because there are pregnancy tests. In addition, a delay in menstruation can serve as evidence of pregnancy.

All this is good when menstruation is regular and delayed by at least 14 days. In this case, the pregnancy test may be positive. However, do not forget that not all tests are highly accurate, so it can show two cherished strips much later than we would like. nine0003

Therefore, it is necessary to pay close attention to the sensations of your body, because it signals the onset of pregnancy long before the manifestation of a delay in menstruation.

If you assume that pregnancy is possible, then listen carefully to your body: it can send you a signal in the form of pulling pains in the lower abdomen. At the same time, the pains will differ in their intensity: one woman will say that the pains are unbearable, the other will not notice them at all. Each woman is individual. nine0003

If each menstruation is preceded by unpleasant pain in the lower abdomen or lower back, you may not understand that once again they are associated with the onset of pregnancy.

Pain in the lower abdomen during pregnancy may be associated with the implantation process. To do this, you need to remember the process of fertilization of the egg by the sperm. After their fusion in the fallopian tubes, the fertilized egg enters the uterus under the action of the movement of cilia in the fallopian tubes. The uterine endometrium is a loose mass where a fertilized egg is implanted. nine0003

The process of implantation is the insertion of a fertilized egg into the endometrium of the uterus. At this time, there is a violation of the integrity of the endometrium, which may be accompanied by unpleasant sensations in the lower abdomen. In addition, sometimes slight dark bloody discharge may appear from the genital tract, which can be perceived as the beginning of another menstruation.

Threatened miscarriage

A fairly common cause of pain in the lower abdomen is a threatened miscarriage. This condition is individual and does not depend on physical exertion or complete rest, but on the condition of the woman and her unborn child. nine0003

Among the reasons that may cause a miscarriage may be:

• severe physical exertion;
• sexual contact;
• malnutrition of the ovum;
• genetic disorders and other causes.

Of course, this is not evidence that a miscarriage will not occur with complete rest. Miscarriage can occur due to genetic abnormalities, and due to stress. No woman is immune from the threat of pregnancy loss. nine0008